HEMOGLOBIN LEVELS CHILDREN OLD W. By W. AMONG SEVEN IN SASKATOON, M.Sc., HAWKINS, AND NUTRITIONAL I N THE as appraisal an globin index formation have provided Besides of factors, intake the in case of recommendation crease being iron is most would be rats one is mg. age. independent of it for hemoglobin protein, some both both daily, metals the at one and level is used mainly however, that hemo- and that of certain are for and and animal experiments of the involved and findings of 7 tO may children as increased but from comments such hemoglobin women, girls children among by year men boys figures part of age BA. KLINE, remembered, importance nutritionally in month adequate of For These important supported blood be probable of iron male. with the should amounts adult i K. DOROTHY YEAR in vitamins. hemoglobin but they hardly constitute nutritional problems. Board of the National Research Council’ recommends mg. 12. of the upon the trace formation or maintenance, The Food and Nutrition a daily It also evidence these status nutrition. depends FOURTEEN CANADA CONSIDERATIONS of nutritional of iron TO 14 it is io reflect the with 2.0 the iron the the i5, opinion inthat This and need of age to women. of Ellis the years tO and that questions 53 opinion Bessey’ that intake, but for became of age. Widdowson and McCance3 have recently reported that with the onset of sexual development the females of some species possess a greater ability to accumulate iron in the liver than do the males, and they have presented some evidence to indicate a governing role of sex hormones. They found that pregnancy rapidly reduced has the liver that stated males. He ence up to the iron in in the case to that and of age of of the only during human iron the Gm. to be about per the than amount of iron and is characterized tional From its small importance factors the period Department since less there slow. iron appears Lapicque4 than those to be no sex of differ- growth. whatever as calcium as that The for iron, The requirement by upon but not of Biochemistry, within by the be emphasized level the body to the the in comparison order of magnesium body nature and extent Saskatoon, Gm. i is judged in much quantitative are neglected. of Saskatchewan, 2.78 in the the be explained small of for is present between University are requirement iron the hemoglobin is very which child’s difference can be, sodium, conservation should may it and respectively. of iron bearing losses, of is magnesium. which The time such same was considerably Whether or not there is a sex difference in the storage be more factors operating to deplete this reserve Probably the iron intake of the female is of nutritional of the menopause, while in the male it need be con- requirement, day reaccumulation would the of minerals that contain years. i female. to and livers to menstrual there up rats, female this humans, importance The of female human attributes of sidered iron greaten importance of its very metabolism, low that The excretion. other child’s Canada. nutri- greater W. need for protein a relationship the quality and HAWKINS AND dietary casein been shown,5 of hemoglobin.6’ protein oven as has gluten Among also the comparatively those importance ranged to ards for reference are the averages and from 14.5 those 12. to is questionable up to the year 13 years because 1933 of 358 Florida Columbia Saskatchewan Anderson i483 ,i.8 Pett, 1456 13.3 Pett - Britain 500 13.1 Hamilton, Ont York, Saskatoon, and i children Kracke8 of 5,ooo Children cc al.24 & Sandstead” Hanley and Med. 13.3-13.6 I and PcrkinsH Hanley’8 Res. Council, MacKay, Wills Gt. and Britain” Binghan’8 2.00 11.5 Hawkins, Leeson and McHenry” Ont i8 11.4 Hawkins, Leeson and McHenry2’ Sask 1669 13.6 Hawkins Scandinavian year-old for children, at an altitude #{182} Kaucher Britain children, children. within the These 7 tO 14 which are are in good year age has formation Authors ,i.8 Great in the of Denver. More useful for American, English, Hgb Great East among 13.5 I of egg animals per ioo ml. of blood in 6 to 7 yearThe value of these figures as stand- Values Gm. Michigan values of the altitude by Wintrobe9 given Av. Children acids Colorado, Gm. old. i-Hemoglobin No. Locality hemoglobin 13.3 superiority in anemic CHILDREN at Denver, of With regard to is evidence that The amino AMONG recorded an average in important. of certain Andresen TABLE British 2.79 KLINE regeneration LEVELS early of Mugrage feet. They old children K. is particularly in hemoglobin HEMOGLOBIN gives DOROTHY over that of the adult should always be considered. between hemoglobin and protein nutrition, there of the albumin W. I2..9 for 6 to io agreement which group, and Kline year-old, and with more are presented 13.4 for to ii recent figures in table i. for The British figures shown in the table have been calculated from the Haldane standard of 14.8 as ioo per cent. This is the figure recently given by King et al.’#{176} in place of the previously accepted 13.8. King et al. calculated the hemoglobin content of blood from its iron content, using H#{252}fner’s (1894) figure of 0.334 for the percentage of iron in hemoglobin. Later and probably more reliable figures are at variance with that of H#{252}fnen:Bernhant and Skeggs” found 0.340, and Drabkin,” 0.33 If the figure 0.340 are thus reduced 8. figures bloods gave about than on the basis this by cent. Gibson calculated culated its the iron oxygen the Haldane standard becomes 14.5, and the British extent of about 2. per cent. King et al. found that higher hemoglobin capacity. Figures Harrison’3 distinction from from used, to the 3 pen cent of oxygen and A valid S between showed these content of blood capacity represents values published on the basis of iron content about a year previous to a corresponding two values represents functional difference probably total of about is that pigment, pigment. 2. pen hemoglobin and It illustrates that calthat HEMOGLOBIN 2.80 differences in methods ences among The object among 7 when the CHILDREN of standardization tO THE In May and June toon public-school TABLE AMONG may IN be one SASKATOON factor responsible hemoglobin values reported by various workers. of the present survey was to establish in this area healthy reference LEVELS 14 year old question of anemia SASKATOON of 1948, children. i-Variation children, which of Hemoglobin Values hemoglobin be used values as standards for arises. SURVEY, hemoglobin This was could for differ- METHODS AND determinations about a third with Age and RESULTS were of the Sex among 7 done to Year 7-14 on 1669 age 14 Old Saskagroup in Saskatoon Children Range Age No. Av. of Children S. D. Gm. 7 98 11.1-14.9 13.1 0.91 8 22.3 11.8-15.4 23.3 0.84 9 89 ii.6-i.8 13.5 0.93 10 101 22.5-15.5 13.6 II 105 11.0-16.7 13.7 ,i.o-,6.x 13.9 0.92. Boys 98 Ii ,,.8-,6.i 14.1 0.91 14 207 11.0-16.4 14.4 1.03 7 115 10915.4 13.0 o.86 8 105 zi.-i.6 13.2. 9 109 I1.515.4 13.4 o.8i 0.83 10 113 ,o.o-,6., 13.5 0.94 ii ,o8 11.1-16., 13.5 o.8i ii.-i6.z 23.9 0.95 i,.8-i6.i 14.0 0.97 II.8I6.3 13.9 1.01 13 98 109 24 city. o.88 105 12. the o.86 . 13 Girls Entire % Hc-b 8 Boys 7-14 82.7 11.1-16.7 13.7 o.86 Girls 7-14 842. 10.0-16.3 13.5 i.i6 10.0-16.7 13.6 o.8i the Saskatoon Group In 7-14 1938, Dr. Griffith 1669 Binning,’4’ ‘ Medical Officer of School Board, had studied the incidence of goiter in these schools, and had concluded that factors of age, sex, race, and social condition were involved. Under Dr. Binning’s direction the schools for our study were chosen so as to provide a sample as representative as possible of the various ponents of this population group. Determination of hemoglobin was done on finger tip into globin method and the figure calculation. socio-economic capillary a calibrated pipet, and measurement was made of Collier.16 This was standardized by blood 0.340 as the percentage of iron in hemoglobin and blood taken racial from comthe by the cyanmethemoiron determinations, was utilized in the W. At the foot of table the distribution is shown TABLE W. 2. HAWKiNS are shown for 3.-Distribution AND the boys K. hemoglobin and of Hemoglobin DOROTHY girls Values values 7-14 Boys Class obtained, separately, among 2.81 KLINE Year and for Old Saskatoon in table entire group. Children Entire Group Number % the Girls Interval Gm. and % -- Number Number 11gb 10.0-10.9 0 11.0-11.9 3 0 4 31 12..0-12..9 163 2.0 13.0-13.9 318 14.0-14.9 2.2.2. 3 0 35 4 0 66 4 197 2.4 360 ii 38 336 40 654 39 2.7 2.21 2.5 433 i6 53 6 15.0-15.9 78 9 16.0-16.9 15 2. 7 8 131 I 2.2. I 700 39 600 500 26 400 22 U) 0 0 300 U) 2) 04 ‘4 0 200 22 0 C 54 8 U Li 2) 04 100 4 1 9 10 11 12 13 14 Hemoglobin in FiG. Figure i is group, which figures Our a graphic representation of the 15 Cm. 16 17 18 % i. distribution of values indicates the shape of the distribution curve. may be regarded as maximum to the extent that among total blood the entire pigment 3 2.82. HEMOGLOBIN was measured. as is also by Drabkin LEVELS AMONG Standardization measurement and Austin’7 by CHILDREN iron IN content SASKATOON of blood of pigment as cyanmethemoglobin, to be an ideal pigment for is responsible for which has determination the this, been said of total concentration. DISCUSSIoN Our average Wintrobe, of 13.6 and for children as the ages. values be made consideration of is not is of the others of these of hemoglobin groups should practiced worked of the slightly figures sidered. 3 per cent, the and dental greater thinness, 14 a wider age province. and British ii.8. British group than Their range comparisons comparable population can be made only after by various did we, and workers, Columbia, the and range and this survey in included. about values, also with serum where the children pen cent i 10.3 regard did tO and evidence consume 16.3, iS in the that this did not necessarily health among Saskatchewan be past much better rickets, milk, and incidence was said Saskatchewan correspond children conlower, to of as also both acid levels. The fat by pinching, percent ii had were considered to not they average were ascorbic of subcutaneous Columbia, examined of hemoglobin in British of them had low by the estimation British however, by reported a of to group, to underweight. appears to be quite estimated the proportion of Saskatoon public-school children below the Baldwin-Wood standard to be between 4.7 and 6 per cent on routine measurings during the school year 1947-48. The high hemoglobin levels which we found may also be a reflection of good general health. Hemoglobin levels reported by Pett and Ogilvie’9 among children examined by 10 per Dr. cent they the in given of any average of 13 .3 slightly lower, but the when differences in method are conof anemia among these children to be but was pointed out The degree of general used average highest in methods, workers on comparisons Saskatchewan defects; the and Hanley’8 carried out a nutrition which the city of Saskatoon was not children postural porportion as judged cent The as the is among it standards Columbia Columbia and per to 8 pen In it high. Pett among 1946, VALUES of magnitude but different Accurate the among hematologists. as compared 15.7, than but order i, of differences among in the a survey. tO be Because HEMOGLOBIN narrower than ours, and their are quite comparable, particularly The authors judged the incidence ducted 10.0 same in table differences with children THE reported by with caution. In May and June of five areas of Saskatchewan, They OF Binning cent or more them in various parts of Canada average age groups are compared. Two groups 1946’#{176} had among the lowest hemoglobin one of the chief 35 per cent.” Saskatoon laboratory” is about we have great to affect able to suppose, found defects the by Mugrage was i ,6oo average and underweight, feet expressed however, about pen cent lower than ours when the of children studied in Ontario in 1945 and levels of any reported, and among them the above the sea that Andresen level. opinion hemoglobin in Denver. of which In a previous that level altitude incidence this A recent is not group. determining study group was from this publication altitude of a population is a factor in one of It seems the 2.00 sufficiently normal high reasonvalues adults in W. Mexico City’3 for men, and portant The we has revealed of 15.2. for factor question established are aware influence the TABLE W. HAWKINS values whether for limited areas. of no that women. here. arises values Outside DOROTHY K, unusually the altitude to serve as standards of factors geographic directly factors 2.83 KLINE appear likely Very particular hemoglobin AND high: an average of of 7,457 feet is an for reference influencing other than 4.-Variation of Hemoglobin Values altitude with Boys No. that might Age and Sex Selected among Year 7I4 Old Av. of Children 7 91 8 9 114 S. D. 11gb 11.1-14.9 13.1 0.9! 1I.815.4 13.4 0.83 74 ii.6-i.8 13.6 0.95 io 87 11.5-15.2. 13.6 0.85 II 91 11.9-16.7 13.6 0.84 Ii 84 xi.o-x6.i 13.8 1.01 13 92. 11.3-16.2. 14.1 o.88 12.0-16.4 14.4 1.11 14 Girls 103 7 99 10.9-15.0 13.0 0.84 8 98 ix.-x.6 13.2. 0.84 9 99 11.5-15.4 13.4 0.83 io.o-,6.z 13.6 0.92. o.8i 100 10 II 92. xi.i-i6., 13.6 Ii 8i ii.-i6.z 13.9 0.90 ,,.8-,6.i 14.0 0.97 12.1-16.3 13.9 0.97 101 13 77 14 Boys 7-14 736 11.1-16.7 13.7 0.89 Girls 7-14 748 10.0-16.3 13.6 0.87 10.0-16.7 13.6 0.77 Entire Group both boys in hemoglobin cent Saskatoon group, of the ported similar It has been 1484 7-14 THE girls be health, children Gm. and should general Range Age Among im- level. Saskatoon 8 per 17.7 EFFECT and OF girls from over and also same age. surveys. previously AGE, the the shows These stated SEX, age AND of 7 seven-year the SELECTION 14 there period. the similarity findings agree that tO OF in hemoglobin with those object of this hemoglobin values among provide a range of values apparently healthy public-school which could be used for reference anemia in mind, arises. made, and their If an individual With this hemoglobin is ostensibly a selection values were healthy, is an increase Table values (table reasonable who was boys have healthy re- to discover children, and thus when the question of obviously tabulated it seems in the between of others survey of about this 2. shows subjects to of was 4). to conclude that the 2.84 HEMOGLOBIN hemoglobin level more reliable cause of 89 per group, which of such of the not is evident good opinion state we differ general proportion hematologic had subject the table 4 are values to more selected however, are compared. the that those for This might be- found than group, from any pigment regarding been called data of respiratory knowledge have and 2. SASKATOON no other essentially, if table IN adequacy of studied for what did CHILDREN of the children Values cent, a large In our evaluation the unimportance with. On the other flection AMONG unsatisfactory of illness. other dealt same individuals. pen cent degree generally is adequate. in assisting the healthy Eleven LEVELS in usual is, the the entire indicate of such selection when a large number of subjects is hand, it may be evident particularly in this case as a rehealth among these children, since the selected group was of the whole. SUMMARY In May and June of a survey 1948 of hemoglobin values was carried out on 842. girls and 82.7 boys, ages 7 tO 14 inclusive, in Saskatoon public schools, who repnesented about a third of this population group in the city. Values for girls ranged from 10.0 to 16.3 Gm. per ioo ml. of blood, with an average The of ported The corresponding the whole group 13.5. average for for children age groups were parts of Canada. Values from near ity for of these slightly ages. higher in hemoglobin values 7 tO average those values for reported .2. and i even re- 16.7, tO the highest children in the different groups in other for comparable same age were similar. to near 14 in the 14 year There was an increase old group. The similar- for both boys ages, of age, are years 14 for boys were i which is among 13.6, The than boys and girls of the in the 7 year old group 13 crease from workers. values was Eleven per cent of the children illness. No significant differences removing this group. and in girls of these agreement with had been subject to more appear when the above and the small observations in- of other than the usual degree figures are corrected of by ACKNOWLEDGEMENTS We arc survey but could in the sincere To and indebted not have been preparation to Dr. Griffith carried out. of this paper, Binning His were for interest very his and much help advice, and not appreciated, cop:ration, only and during without which course of the the we should like this work, to render him our for their courtesy thanks. the principals and staffs of the schools included in the survey extend we thanks help. Dr. the greatly H. B. Collier, course Head of the survey, of the and Department in the of Biochemistry, preparation of this rendered paper. We valuable wish help and to acknowledge advice this during with our thanks. Helpful suggestions Saskatchewan, Toronto. were and \Ve extend received Dr. from to them E. W. from Dr. McHcnry, our L. B. Jaqucs, Professor Professor of Public of Physiology at the University of Nutrition at the University of Recommended dietary Health thanks. REFERENCES I NATIONAL revised RESEARCH 1948. COUNCIL Washington, Reprint 1948. and Circular Series, No. 22.9: allowances, W. L. N., 2 ELLIS, 3 AND E. M., WIDD0w50N, ,J. Biochem. 4 L. : Une LAPICQUE, A. : The effect DOROTHY of diet on K. the KLINE hemoglobin concentration of the blood. R. A. : Sexual MCCANCE, differences in the storage and metabolism of iron. i8. vicille donn#{233}eperdue dc l’hommc. M., DAMODARAN, AND 1935. AND 577, 42.’ de fer quc cclui 5 58i, 113.’ HAWKINS 0. BESSEY, Physiol. Am.J. W. AND de vuc: Compt. rend. P. VIJAYARAGHAVAN, Ic foic Soc. de Ia fcmmc de Biol. K. : Proteins conticnt 2.14, x.i.’ and deux fois et dcmie moms 1947. blood formation. Current Sc. 12.’ 115, 1943. J. 6 ORTEN, normal 7 M., H. M., globin. II. Lancet, 253: ‘47.. 12 19, inability Fed. in hemoglobin formation. Philadelphia, J. hemoglobin Current Lippincott, Philadelphia, I. D. P. , DONALDsON, PETERSON, of human or beef Proc. 4? i6o, 1945. M., standard 77, ii.’ to support 1945. 1941. Lea AND Sc. globin & Febiger, R. , SISSON, 1942.. R. B., compared R. G., MACFARLANE, D. H. : Determination STRANGWAYS, with iron and of hemo. gasometric estimations. 1947. L. : The Sic.&sGs, AND iron content of crystalline human hemoglobin. J. Biol. J. M. Chcm. 1943. L. : Crystallographic and optical properties of human hemoglobin. Am. Sc. 209.’ 1945. Q. GIBSON and 14 tyrosinc Blood. R. P., Haldane 789, D. DRABKIN, i68, 13 The F. W., BERNHART, J. O’BRIEN, E. : The isolcucine. added Hematology. WOOTON, M., GILcHRI5T, , J. BOURQUE, without of the M. M. : Clinical J. E. KING, J OPE, Ii rat and R. R. : Diseases 8 WINTROBE, AND in the K. M. : Histidinc YESHODA, 8 KRAcKE, 10 A. U., ORTEN, hemopoicsis H., iron AND of blood G. : The BINNING, 533, ‘935. I5......: A study incidence of goitre Saskatoon. in H. B.: The COLLIER, D. C. : Blood hemoglobin: in men and women. Biochem. of goitre amongst Saskatoon HARRISON, content J. Canad. standardization Pub. blood of the relationship 2.47, ,6. school childrcn-19;4. J. Health. p. 393, hemoglobin between oxygen capacity 40.’ Canad. M. J. A. 32.’ ‘939. Aug., determinations. Canad. M. J. A. 550, 50.’ ‘944. D. L., 17 DRABICIN, 89, 112.’ 18 PE1-r, AND B., AND , 20 HAWKINS, AND W. Jones 22 HAWKINS, 23 ROBLES feet). 24 KAUCHER, and young studies. red Study M., AND made on Nutritional D.: other (with 28 MACKAY, of men RESEARCH observations 22.’ ,i8, COUNCIL upon Biol. Chem. in British Columbia J. 1948. and M. A. levels in j8.’ 353, Canadian population 1947. W.: HARRISON, of of hematologic Nutritional aspects 1946. among 351, levels the number standards healthy persons. A. P., THOMAS, of the Hartman Saskatchewan college in of erythrocytes, volume of City (altitude: 7,457 Mexico Blood. 3.’ 66o, 1948. R. U. RUTLEDGE, M. M., W., LAMECK, children. VII. Hemoglobin. J. Am. Diet. A. 24.’ 496, 1948. H. R.: Nutritional appraisal and demonstration program AND of the 1947. levels of children in British Columbia. Bull. 1946. Special serum Report protein Series levels). M. M., WILLS, L., AND BINGHAM, K.: the fighting services and of civilians. in 502., Determination 26 A. 6.’ MOSLEY, U. S. public health service. J. Am. Diet. A. 23.’ 101, PETT, L. B., HANLEY, F. W., AND PERKINS, E.: Hemoglobin M. children ages. Canad. Hemoglobin Pub. Health. B.: Hemoglobin ANDERSON, 27 MEDICAL IV. Hemochromogens.J. school 1948. hundred SANDSTEAD, J. 2 Vancouver AND J. H. COLLIER, x6i, status E. W.: Canad. and two at different Canad. M. A. E. W., AND TERAN, E. Z., MOYER, K., AND GONZALEZ hemoglobin R. levels study. jS.’ among 2947. MCHENRY, McHENRY, A.J. cells, E. F.: BEACH, M. survey 287, women. J., LEESON, J., GIL, ;6.’ LEESON, Canad. packed J. A. Memorial School health W. W., BARSKY, J., women. A nutrition G. F.: Hemoglobin H. J., AND W., children R., 21 CRAWFORD, M. Canad. OGILVIE, groups: F. W.: HANLEY, Saskatchewan. 19 H.: Spectrophotomctric AUSTIN,J. 1935. L. No. ii: London, Economic Brit. Hemoglobin in Great Office, the hemoglobin status M. levels H. M. Stationery J. i. and 711, 1946. Britain in 1943 I9.. level of children
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